Chapter 13 Cardiovascular System (gtallo)

apex

The bottom of the heart

base

The top of the heart

4

-endocardium, myocardium, epicardium, and pericardium

How many layers does the heart consist of?

precordium

The area on the anterior chest wall that covers the heart.

left atria

This chamber pumps oxygenated blood to the left ventricle.

right atria

This chamber receives deoxygenated blood and pumps it to the right ventricle.

left ventricle

This chamber pumps oxygenated blood to the aorta.

right ventricle

This camber pumps deoxygenated blood to the lungs.

antrioventricular valves

Separates the atria and ventricles; includes the mitral and tricuspid valves:

semilunar valves

Separates the ventricles from the pulmonary artery and aorta;

includes the pulmonary and aortic valves:

cardiac cycle

A complete heartbeat consisting of contraction and relaxation of both atria and both ventricles.

systole

Contraction of the heart

diastole

Relaxation of the heart

6L per minute

What is a normal cardiac output?

pacemaker; it initiates electrical impulses

Sinoatrial (SA node) is known as the _______.

depolarization

Ions move from a negative to positive charge which allows the heart to contract.

Repolarization

The cells return to their normal charge after depolarization.

P wave

Atrial depolarization wave

QRS complex

Ventricular depolarization wave

T wave

Ventricular repolarization wave

valve closure

How are heart sounds created?

Closure of the atrioventricular valves

How is the s1 "lub" sound created?

apex of the heart (bottom)

S1 sounds are louder at the:

Closure of the semilunar valves

How is the s2 "dub" sound created?

base of the heart (top)

S2 sounds are louder at the:

S3

An extra heart sound that occurs early in diastole (after s2)- is related to the deceleration of blood against the ventricles

"ventricular gallop"

S3 is also known as:

40 years of older

-can be a sign of heart failure

S3 can be normal in young adults and athletes but is abnormal in the age group of:

S4

An extra heart sound that occurs at the end of diastole (before s1)- is related to the atria working hard to contract

"atrial gallop"

S4 heart sound is also known as:

heart murmurs

A swooshing sound that are caused by turbulent blood flow in the cardiovascular system

-can occur anywhere in the cardiac cycle

-can be cognitional or developed

innocent/physiological murmur

A murmur with no symptoms, not caused by a heart problem. Typically, it occurs from extra blood flow in the heart.

abnormal/pathological murmur

A murmur from age-related changes. Heart disease, or a structural problem are the causes.

palpitations and SOB

Patients with an abnormal murmur may experience:

I-IV (6 grades) in order from lowest to highest

How many grades are on the heart murmur grade scale?

The sound it produces from the amount and thickness in the blood.

What determines the intensity of a heart murmur?

crescendo

Stars soft and gets louder:

descrendo

Starts soft and gradually fades away:

plateau

Same intensity configuration of a murmur:

ejection clicks

High-pitched sounds that occur at the moment of maximal opening of the semilunar valves.

-reflective of cardiac output

-typically heard after S1

mitral valve prolapse

A midsystolic ejection click is a cardinal finding of:

opening snap

Loud, high-frequency found from a stenoic valve opening.

pericardial friction rub

Friction of the visceral and parietal layers

pericardial effusion

A collection of fluid between the pericardial sac and the myocardium.

lipid profile

Blood test used to measure HDL and LDL.

good cholestrol

High density lipoprotein (HDL)

Bad Cholesterol

Low density lipoprotein (LDL)

coronary artery disease

Atherosclerosis of the coronary arteries; predictor for strokes

<200 mg/dL

Normal total cholesterol level:

creatine kinase

An enzyme that will increase when it detects damaged cardiac tissue due to decreased oxygenated.

4 to 6 hours

The creatine kinase level will rise ______ after someone experiences chest pain.

troponin

A protein in the cardiac muscle that is released when there is heart damage.

3-4 hours

Troponin is released ______ after damage.

electrocardiogram (EKG)

A measurement of heart electrical activity.

echocardiogram

An ultrasound of the heart.

Holter monitor

A portable electrocardiograph that is worn by an ambulatory patient to continuously monitor the heart rates and rhythms over a 24-hour period.

Exercise stress test

Study that evaluates cardiac function during physical stress by walking on a treadmill. Cardiac function is monitored during this study.

rheumatic fever

Untreated strep throat that can damage the heart

Smoking, diet, exercise, hygiene, obesity

Modifiable cardiac risk factors:

genetics, age, sex

Non-modifiable cardiac risk factors:

Coronary Heart Disease (CHD)

The #1 cause of death in women:

1 out of 3 women die from this

heart-healthy diet

A diet that includes fruits/vegetables, whole grains, lean meat, low sodium and lowfat. Eliminating unsaturated fats such as greasy foods.

at least 20 mins 3x a week

What amount of exercise lowers the risk of CHD?

angina pectoris

Chest pain

Onset

Location

Duration

Characteristics

Aggravating/Alleviating Factors

Related Symptoms

Treatment

Severity

OLDCARTS to assess a symptom

Severe chest pain often described as an elephant sitting on the chest

Most classic symptom of a myocardial infarction:

heart palpitations

Increased awareness of the heart beating; known as a "fluttering" or racing feeling

central cyanosis

Cyanosis of the mucous membranes such as the tongue, conjunctiva, lips, and skin.

peripheral cyanosis

Cyanosis of the peripheral extremities such as the nailbeds, palms, soles, and tips of ears.

nocturia

-can be a symptom of CHF

Excessive urination at night.

diaphoresis

Profuse or excessive sweating.

30 degree

The HOB should be at a ______ angle when completing a cardiac assessment.

mitral

What is the point of maximal impulse?

heaves or lifts

Sustained, forceful, outward thrusting of the ventricle secondary to increased workload.

apical

Sometimes, you can see the _____ pulse at the 5th ICS mid-clavicular line.

at the apex

Where would you see a left ventricular heave?

at the sternal border

Where would you see a right ventricular heave?

left lateral recumbent position

What position is best when palpating the apical pulse?

Palpate the carotid or radial pulse to compare

While auscultating the apical pulse, what do you do with your other hand?

pulse deficit

Difference between the apical and radial pulse rates; is concerning if it is greater than 10

high-pitched sounds

Use the diaphragm to listen to:

low-pitched sounds

Use the bell to listen to:

Ask them to hold their breath.

What do you instruct your patient to do when listening to the carotids?

Split s2

Normal heart sound that affected by respirations.

reduce deaths from HD and strokes

Main cardiac goal of healthy people 2030:

-low levels of HDL

-high levels of total cholesterol and LDL

The US Preventative Services Task Force recommends that the risk factors for HD are:

Every 4 to 6 years

The American Heart Association recommends all adults aged 20 or over have their cholesterol checked how often?

cholesterol and cancers

Red meats can put an individual at risk for _______.

tetralogy of fallot

Congenital malformation is commonly seen in infants

turning blue or extreme fatigue

A key sign of cardiac malfunction in infants or children:

extreme fatigue or changes in ADLs

A key sign of cardiac malfunction in eldery: